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Test Bank for Varcarolis' Foundations of Psychiatric-Mental Health Nursing a Clinical Approach 9th Edition by Margaret Jordan Halter
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Test bank For Varcarolis Foundations of Psychiatric-Mental
Health Nursing 9th Edition 9780323697071 | All Chapters with
Answers and Rationals
The scope of practiced for an advanced nurse practitioner would include which intervention?
a. Conducting a mental health assessment.
b. Prescribing psychotropic medication.
c. Establishing a therapeutic relationship.
d. Individualizing a nursing care plan. - ANSWER: ANS: B
In most states, prescriptive privileges are granted to master's-prepared nurse practitioners and clinical
nurse specialists who have taken special courses on prescribing medication. The nurse prepared at
the basic level is permitted to perform mental health assessments, establish relationships, and
provide individualized care planning.
A nursing student expresses concerns that mental health nurses "lose all their clinical nursing
skills." Select the best response by the mental health nurse.
a. "Psychiatric nurses practice in safer environments than other specialties. Nurse-to-
client ratios must be better because of the nature of the clients' problems."
b. "Psychiatric nurses use complex communication skills as well as critical thinking
to solve multidimensional problems. I am challenged by those situations."
c. "That's a misconception. Psychiatric nurses frequently use high technology
monitoring equipment and manage complex intravenous therapies."
d. "Psychiatric nurses do not have to deal with as much pain and suffering as
medical-surgical nurses do. That appeals to me." - ANSWER: ANS: B
The practice of psychiatric nursing requires a different set of skills than medical-surgical nursing,
though there is substantial overlap. Psychiatric nurses must be able to help clients with medical as
well as mental health problems, reflecting the holistic perspective these nurses must have. Nurse-
client ratios and workloads in psychiatric settings have increased, just like other specialties. Psychiatric
nursing involves clinical practice, not just documentation. Psychosocial pain and suffering are as real
as physical pain and suffering.
When a new bill introduced in Congress reduces funding for care of persons diagnosed with mental
illness, a group of nurses write letters to their elected representatives in opposition to the legislation.
Which role have the nurses fulfilled?
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice - ANSWER: ANS: C
An advocate defends or asserts another's cause, particularly when the other person lacks the ability
to do that for self. Examples of individual advocacy include helping clients understand their rights or
make decisions. On a community scale, advocacy includes political activity, public speaking, and
publication in the interest of improving the human condition. Since funding is necessary to deliver
quality programming for persons with mental illness, the letter- writing campaign advocates for that
cause on behalf of clients who are unable to articulate their own needs.
4. A family has a long history of conflicted relationships among the members. Which family member's
comment best reflects a mentally healthy perspective?
a. "I've made mistakes but everyone else in this family has also."
b. "I remember joy and mutual respect from our early years together."
c. "I will make some changes in my behavior for the good of the family."
d. "It's best for me to move away from my family. Things will never change." - ANSWER: ANS: C
The correct response demonstrates the best evidence of a healthy recognition of the importance of
relationships. Mental health includes rational thinking, communication skills, learning, emotional
growth, resilience, and self-esteem. Recalling joy from earlier in life may be healthy, but the correct
,response shows a higher level of mental health. The other incorrect responses show blaming and
avoidance.
5. Which assessment finding most clearly indicates that a client may be experiencing a mental illness?
a. reporting occasional sleeplessness and anxiety.
b. reporting a consistently sad, discouraged, and hopeless mood.
c. being able to describe the difference between "as if" and "for real."
d. experiencing difficulty making a decision about whether to change jobs. - ANSWER: ANS: B
The correct response describes a mood alteration, which reflects mental illness. The distracters
describe behaviors that are mentally healthy or within the usual scope of human experience.
6. Which finding best indicates that the goal "Demonstrate mentally healthy behavior" was achieved
for an adult client?
a. being willing to work towards achieving ideals and meeting demands.
b. behaving without considering the consequences of personal actions.
c. aggressively meeting personal needs without considering the rights of others.
d. seeking help from others to avoid assuming responsibility for major areas of own
life. - ANSWER: ANS: A
Mental health is a state of well-being in which individuals reach their own potential, cope with the
normal stresses of life, work productively, and contribute to the community. Mental health provides
people with the capacity for rational thinking, communication skills, learning, emotional growth,
resilience, and self-esteem. The correct response describes an adaptive, healthy behavior. The
distracters describe maladaptive behaviors.
PTS: 1 DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Evaluation MSC: Client Needs: Psycho
7. A nurse encounters an unfamiliar psychiatric disorder on a new client's admission form. Which
resource should the nurse consult to determine criteria used to establish this diagnosis?
a. International Statistical Classification of Diseases and Related Health Problems (ICD-10)
b. The ANA's Psychiatric-Mental Health Nursing Scope and Standards of Practice
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
d. A behavioral health reference manual - ANSWER: ANS: C
The DSM-V gives the criteria used to diagnose each mental disorder. It is the official guideline for
diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a psychiatric
illness.
PT
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource
would have the most complete information?
a. Nursing Outcomes Classification (NOC)
b. DSM-V
c. The ANA's Psychiatric-Mental Health Nursing Scope and Standards of Practice
d. ICD-10 - ANSWER: ANS: B
The DSM-V details the diagnostic criteria for psychiatric clinical conditions. It is the official guideline
for diagnosing psychiatric disorders. The other references are good resources but do not define the
diagnostic criteria
9. Which individual behavior demonstrates resilience?
a. Repress stressors associated with a divorce.
b. Continuing to grieve the death of a spouse for 5 years.
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire.
d. Taking a temporary job to maintain financial stability after loss of a permanent
job. - ANSWER: ANS: D
Test bank Varcarolis' Foundations of Psychiatric-Mental Health Nursing 9th Edition 5
Resilience is closely associated with the process of adapting and helps people facing tragedies, loss,
trauma, and severe stress. It is the ability and capacity for people to secure the resources they need
,to support their well-being. Repression and protracted grief are unhealthy. Living in a shelter for 2
years shows a failure to move forward after a tragedy. See related audience response question.
10. The relationship of the North American Nursing Diagnosis Association (NANDA) is to clinical
judgment as Nursing Interventions Classification (NIC) is to what?
a. client outcomes.
b. nursing actions.
c. diagnosis.
d. symptoms. - ANSWER: ANS: B
Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis Association,
identifies diagnostic statements regarding human responses to actual or potential health problems.
These statements represent clinical judgments. NIC (Nursing Interventions Classification) identifies
actions provided by nurses that enhance client outcomes. Nursing care activities may be direct or
indirect.
An adult says, "Most of the time I'm happy and feel good about myself. I have learned that what I get
out of something is proportional to the effort I put into it." Which number on this mental health
continuum should the nurse select?
Mental Illness Mental Health 1 2 34 5
A. 1
B. 2
C. 3
D. 4
E. 5 - ANSWER: ANS: E
The adult is generally happy and has an adequate self-concept. The statement indicates the adult is
reality-oriented, works effectively, and has control over own behavior. Mental health does not mean
that a person is always happy.
12. Which disorder is an example of a culture-bound syndrome?
a. Epilepsy
b. Schizophrenia
c. Running amok
d. Major depressive disorder - ANSWER: ANS: C
Culture-bound syndromes occur in specific sociocultural contexts and are easily recognized by people
in those cultures. A syndrome recognized in parts of Southeast Asia is running amok, in which a
person (usually a male) runs around engaging in furious, almost indiscriminate violent behavior.
13. What does the DSM-V classify?
a. deviant behaviors
b. present disability or distress
c. people with mental disorders
d. mental disorders - ANSWER: ANS: D
The DSM-V classifies disorders people have rather than people themselves. The terminology of the
tool reflects this distinction by referring to individuals with a disorder rather than as a "schizophrenic"
or "alcoholic," for example. Deviant behavior is not generally considered a mental disorder. Present
disability or distress is only one aspect of the diagnosis.
. A citizen at a community health fair asks the nurse, "What is the most prevalent mental disorder in
the United States?" Select the nurse's correct response.
a. Schizophrenia
b. Bipolar disorder
c. Dissociative fugue
d. Alzheimer's disease - ANSWER: ANS: D
The 12-month prevalence for Alzheimer's disease is 10% for persons older than 65% and 50% for
persons older than 85. The prevalence of schizophrenia is 1.1% per year. The prevalence of bipolar
disorder is 2.6%. Dissociative fugue is a rare disorder.
, 15. In the majority culture of the United States, which individual has the greatest risk to be labeled
mentally ill?
a. One who describes hearing God's voice speaking.
b. One who is usually pessimistic but strives to meet personal goals.
c. One who is wealthy and gives away $20 bills to needy individuals.
d. One who always has an optimistic viewpoint about life - ANSWER: ANS: A
The question asks about risk. Hearing voices is generally associated with mental illness, but in
charismatic religious groups, hearing the voice of God or a prophet is a desirable event. Cultural
norms vary, which makes it more difficult to make an accurate diagnosis. The individuals described in
the other options are less likely to be labeled mentally ill.
16. A client's relationships are intense and unstable. The client initially idealizes the significant other
and then devalues him or her, resulting in frequent feelings of emptiness. This client will benefit from
interventions to develop which aspect of mental health?
a. Effectiveness in work
b. Communication skills
c. Productive activities
d. Fulfilling relationships - ANSWER: ANS: D
The information given centers on relationships with others that are described as intense and unstable.
The relationships of mentally healthy individuals are stable, satisfying, and socially integrated. Data
are not present to describe work effectiveness, communication skills, or activities.
Which belief will best support a nurse's efforts to provide client advocacy during a multidisciplinary
client care planning session?
a. All mental illnesses are culturally determined.
b. Schizophrenia and bipolar disorder are cross-cultural disorders.
c. Symptoms of mental disorders are unchanged from culture to culture.
d. Assessment findings in mental illness reflect a person's cultural patterns. - ANSWER: ANS: D
Symptoms must be understood in terms of a person's cultural background. A nurse who understands
that a client's symptoms are influenced by culture will be able to advocate for the client to a greater
degree than a nurse who believes that culture is of little relevance. The distracters are untrue
statements.
PTS: 1 DIF: Cognitiv
18. A nurse is part of a multidisciplinary team working with groups of depressed clients. One group of
clients receives supportive interventions and antidepressant medication. The other group receives
only medication. The team measures outcomes for each group. Which type of study is evident?
a. Incidence
b. Prevalence
c. Comorbidity
d. Clinical epidemiology - ANSWER: ANS: D
Test bank Varcarolis' Foundations of Psychiatric-Mental Health Nursing 9th Edition 8
Clinical epidemiology is a broad field that addresses studies of the natural history (or what happens if
there is no treatment and the problem is left to run its course) of an illness, studies of diagnostic
screening tests, and observational and experimental studies of interventions used to treat people
with the illness or symptoms. Prevalence refers to numbers of new cases. Comorbidity refers to
having more than one mental disorder at a time. Incidence refers to the number of new cases of
mental disorders in a healthy population within a given period. See related audience response
question
19. The spouse of a client diagnosed with schizophrenia says, "I don't understand how events from
childhood have anything to do with this disabling illness." Which response by the nurse will best help
the spouse understand the cause of this disorder?
a. "Psychological stress is the basis of most mental disorders."
b. "This illness results from developmental factors rather than stress."
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